By setting the focus on issues of dependence and embodiment, feminist work has and continues to radically improve our understanding of Kant’s practical philosophy as one that is not (as it typically has been taken to be) about disembodied abstract rational agents. This paper outlines this positive development in Kant scholarship in recent decades by taking us from Kant’s own comments on women through major developments in Kant scholarship with regard to the related feminist issues. The main aim is to (...) provide an overview of the philosophical resources already available in the literature as well as a sense of where main interpretive and philosophical challenges currently lie. More specifically, I start with a brief summary of the kinds of statements Kant makes about women that give rise to the many interpretive and philosophical puzzles facing anyone who reads his philosophy carefully. I then provide a brief historical overview of many of the pioneering women Kant scholars who made it possible for there to be so many excellent women scholars in the Kant community today and for firmly establishing the condition of woman as a point of inquiry on the philosophical map. The last section is organized in themes to give the reader a sense of the current, related discussions. I provide an overview of the more recent literature regarding Kant on women, embodiment (sexual objectification, sexual activity, sexual violence, abortion), care relations (marriage, dependents, servants), and systemic injustice (poverty, sex work, and oppression). As we will see, these many engagements with Kant’s philosophy not only help us to better understand our inherited women-undermining and problematic dependency-furthering institutions and practices, but also provide ample philosophical resources that can be utilized in our efforts to envision the project of reform such that we can achieve a better future for each and all. (shrink)

We argue that contemporary conceptualizations of “persons” have failed to achieve the moral goals of “person-centred care” (PCC, a model of dementia care developed by Tom Kitwood) and that they are detrimental to those receiving care, their families, and practitioners of care. We draw a distinction between personhood and selfhood, pointing out that continuity or maintenance of the latter is what is really at stake in dementia care. We then demonstrate how our conceptualization, which is (...) one that privileges the lived experiences of people with dementia, and understands selfhood as formed relationally in connection with carers and the care environment, best captures Kitwood’s original idea. This conceptualization is also flexible enough to be applicable to the practice of caring for people at different stages of their dementia. Application of this conceptualization into PCC will best promote the well-being of people with dementia, while also encouraging respect and dignity in the care environment. (shrink)

In her essay ‘The Curious Coincidence of Feminine and African Moralities’ (1987), Sandra Harding was perhaps the first to note parallels between a typical Western feminist ethic and a characteristically African, i.e., indigenous sub-Saharan, approach to morality. Beyond Harding’s analysis, one now frequently encounters the suggestion, in a variety of discourses in both the Anglo-American and sub-Saharan traditions, that an ethic of care and an African ethic are more or less the same or share many commonalities. While the two (...) ethical perspectives are indeed sisters, in this article I argue, first, that they are not identical twins, and, more strongly, that the family resemblance between the two is significantly less than has been recognized. I highlight key differences between representative forms of an ethic of care and a sub-Saharan communitarian morality, after which I argue, second, that the latter better captures some central feminist concerns and moral considerations generally. That is, I maintain that an African ideal of community, when understood in a philosophically refined way, provides an important, relational corrective to the ethic of care. (shrink)

Medical billing has become so intertwined with patient care, that in order to be truly committed to the physician's telos of managing a patient's medical suffering, it is imperative that physician ought to reexamine many of the ethical considerations about billing.

How do we care well for a human being: ourselves or another? Non-Kantian scholars rarely identify the philosophy of Kant as a particularly useful resource with which to understand the full complexity of human care. Kant’s philosophy is often taken to presuppose that a philosophical analysis of good human life needs to attend only to how autonomous, rational agents—sprung up like mushrooms out of nowhere, without a childhood, never sick, always independent—ought to act respectfully, and how they can (...) be forced to interact rightfully. Questions involving aspects of human life captured by what Eva Kittay aptly phrased “the fact of dependency” (1999) —such as our vulnerable, fragile, and embodied social natures, asymmetrical care relations, and deep systemic injustices—are therefore commonly thought to be beyond the grasp of Kant and of Kantian philosophy. Against this historically prominent understanding of Kant’s practical philosophy, below I engage and draw upon recent Kant scholarship which shows both the inadequacy of such rationalist readings and the fruitfulness of using Kant’s practical philosophy to enhance our understanding of human care relations. After situating my approach in the existing, relevant secondary literature on Kant’s human agent, I explore key features of Kant’s accounts of human nature and the highest good. I pay special attention to his proposal that our human nature comprises reflective and unreflective aspects and patterns that we (ought to) strive to develop, transform, and integrate in wise ways through our faculty of desire. In addition, I emphasize the dangers that our ineradicable propensity to do bad things (evil) poses for our projects of self- and other- care. I proceed by outlining how Kant’s account of moral (ethical and legal) responsibility for self and others is developed through his theories of freedom, that is, through his theory of virtue (virtuous internal freedom with its account of perfect and imperfect duties) and his theory of right (rightful external freedom with its account of innate, private, and public right). On the conception I am advancing, we are pretty messy, fragile, and vulnerable beings whose projects of caring are difficult, ongoing, and complex. On the one hand, we (should) strive to care for ourselves (by striving to manage and heal badly functioning parts and by developing, transforming, and integrating immature or distinct parts of ourselves into good wholes) and for others (assisting them in their projects of management and healing and of developing, transforming, and integrating themselves into good wholes) in ways that are both respectful and attentive to the particular people we are—people with lives of our own to live—and the kinds of relationships we share. On the other hand, we should, and can, be forced to interact rightfully, meaning interaction consistent with one another’s basic (innate, private, and public) rights and, hence, contribute to reform projects that improve our inherited, imperfect legal-political systems with regard to care relations. Bringing Kant’s philosophy into dialogue with care theorists, I conclude, advances the insights of both traditions by showing one way to arrive at a multifaceted, yet unified account of human care relations where our embodied, social as well as our rational natures are given due consideration. (shrink)

Liberal theories of justice have been rightly criticized for two things by care theorists. First, they have failed to deal with private care relations’ inherent (inter)dependency, asymmetry and particularity. Second, they have been shown unable properly to address the asymmetry and dependency constitutive of care workers’ and care-receivers’ systemic conditions. I apply Kant’s theory of right to show that current care theories unfortunately reproduce similar problems because they also argue on the assumption that good (...) care requires only virtuous private individuals. Giving up this assumption enables us to solve the problems regarding both private care relations and systemic injustice. (shrink)

Henry Richardson has recently published the first book ever devoted to ancillary care obligations, which roughly concern what medical researchers are morally required to provide to participants beyond what safety requires. In it Richardson notes that he has presented the ‘only fully elaborated view out there’ on this topic, which he calls the ‘partial-entrustment model’. In this article, I provide a new theory of ancillary care obligations, one that is grounded on ideals of communion salient in the African (...) philosophical tradition and is intended to rival and surpass Richardson’s model, which is a function of Western considerations of autonomy. I argue that the relational approach of the former has several virtues in comparison to the basic individualism of the latter. (shrink)

Much of the discussion of the role of emerging technologies associated with AI, machine learning, digital simulacra, and relevant ethical considerations such as those discussed in the target article, take a relatively narrow and episodic view of a person’s healthcare needs. There is much speculation about diagnostic, treatment, and predictive applications but relatively little consideration of how such technologies might be used to address a person’s lived experience of illness and ongoing care needs. This is likely due to the (...) greater weight or priority given to acute care needs and the role of medical treatment in care provision, but it may also reflect the limitations of current technologies and our limited vision of their potential application. Such limitations are not surprising given that we are still grappling with the complexities and nuances of achieving the ethical and humanistic ideals of care, namely, care that addresses the hermeneutical, relational, contextual, temporal, and agential dimensions of a person’s health and wellbeing. (shrink)

The paper studies two fundamentally different forms in which the concept of care makes its comeback in twentieth-century thought. We make use of a distinction made by Peter Sloterdijk, who argues that the ancient and medieval ‘ascetic’ ideal of self-enhancement through practice has re-emerged in the nineteenth and twentieth centuries, particularly in the form of a rehabilitation of the Hellenistic notion of self-care (epimeleia heautou) in Michel Foucault’s late ethics. Sloterdijk contrasts this return of self-care with Martin (...) Heidegger’s concept of being-in-the-world as ‘total care’ (Sorge), an utterly ‘secularized’ understanding of the human being as irreducibly world-embedded that rejects the classical ascetic ideal of world-secession. We examine further the historical roots and emergence of these contrasting contemporary reappropriations of care in the Western tradition of thought and show them to be rooted in two different ontologies and ethics of the self as either world-secluded or world-immersed, autonomous or constitutively relational. The historical point of divergence of these two approaches to care, we argue, can be found in the Christian transformation of Hellenistic ethics. (shrink)

Both Martin Heidegger and Harry Frankfurt have argued that the fundamental feature of human identity is care. Both contend that caring is bound up with the fact that we are finite beings related to our own impending death, and both argue that caring has a distinctive, circular and non-instantaneous, temporal structure. In this paper, I explore the way Heidegger and Frankfurt each understand the relations among care, death, and time, and I argue for the superiority of Heideggerian (...) version of this nest of claims. Frankfurt claims that we should conceive of the most basic commitments which practically orient a person in the world and define his identity (“volitional necessities”) as naturalistic facts, foundational for and located completely without the normative space of reasons. In support of this he appeals to the supposedly foundational role played in human life by the instinct for self-preservation, what Frankfurt calls the “love of living.” The claim is that in questions of practical identity there is a definite priority of the factual over the normative. Frankfurt’s naturalistic model of volitional necessity is motivated by a misunderstanding of the temporal structure of care, a misunderstanding that helps lead him to an implausible conception of the basic structures of human identity. Heidegger advances an anti-naturalistic conception of caring, one bound up with his way of understanding how human beings relate to their own future. I argue that the existential, temporal, and normative significance that Frankfurt attributes to the naturalized “love of living” is better captured by the Heideggerian claim that human identity is defined by being “for-the-sake-of” certain projects and commitments, a way of being lived out in the way Heidegger calls “being-towards-death.”. (shrink)

Dance, as a mode of physical interaction, offers opportunities to care and be cared for, but this does not mean that dancers will, in fact, care. There may be no moral motivation underlying a lift, dip or intricate sequence of coordinated action. Choreographic scores may (knowingly or not) encourage merely perfunctory movements that are a poor simulacrum to care. Moreover, the caring that is expressed through dance need not transfer to other walks of life. I am not (...) alone in knowing spectacularly talented dancers whose behaviour off the dance floor is far from ethical – from the arrogant and petty to the flagrant abuse that plagues institutions of art and culture. This article considers how dance can illuminate both the acts and sentiments of care, conveying particular ethical orientations that trouble straightforward, absolute moral reasoning. The article frames an enquiry into the relation between ethics and aesthetics of care, drawn from feminist epistemologists Joan Tronto, Maurice Hamington, and Nel Noddings, as well as my own performance research on partnering. I frame a zone between technique and competence, foregrounding care in dance as both a technical and ethical issue. I will consider the necessary conditions by which dancing together can manifest care, rather than suggest blanketly that it always does or even that it should. To make this argument, I will describe and analyse Considered Care, a duet I created in the autumn of 2021 in collaboration with Boston Ballet. This performance research project provided the material from which to consider the concept of need, a condition of care in a dancing situation. I will conclude by considering the relationship between needs and trust in conceptualizing care within partnering. (shrink)

In their strife for designing a moral system where everyone is given equal consideration, cosmopolitan theorists have merely tolerated partiality as a necessary evil (insofar it means that we give priority to our kin opposite the distant needy). As a result, the cosmopolitan ideal has long departed from our moral psychologies and our social realities. Here I put forward partial cosmopolitanism as an alternative to save that obstacle. Instead of demanding impartial universal action, it requires from us that we are (...) equally responsive in all the relationships we stand in. That goes from the local to the cosmopolitan sphere, since I defend that we are related with strangers as co-members of the global community. Thus, partiality not only is accommodated by cosmopolitanism, but actually supports it: only by having meaningful personal relationships we become able to care for distant strangers. (shrink)

This paper attempts to show how Adorno’s thought can illuminate our reflections on the future of work. It does so by situating Adorno’s conception of genuine activity in relation to his negativist critical epistemology and his subtle account of the distinction between true and false needs. What emerges is an understanding of work that can guide our aspirations for the future of work, and one we illustrate via discussions of creative work and care work. These are types of work (...) which cater to persistent human needs, albeit ones that are distorted under present social conditions. Adorno’s thought helps us to understand why this is the case. (shrink)

Laplacean Determinism (his so-called demon argument) is the thesis that every event that transpires in a closed universe is a physical event caused (i.e., determined) in full by some earlier event in accord with laws that govern their behavior. On this view, it is possible, in principle, to make perfect predictions of the state of the universe at any time Tn on the basis of complete knowledge of the state of the universe at time T1. Thus, if identity theory, epiphenomenalism (...) or any other instantiation of Laplacean Determinism is correct, mental events such as free will, intention and other forms of mental agency are tricks of the mind, misleading us into believing our volitional concerns have traction in a world ruled entirely by physical circumstance. Not surprisingly, advocates of free will and related acts of human volition have engaged in spirited debate with adherents to Laplacean orthodoxy, the results of which have been far from conclusive. Rather than join these deliberations, I wholly embrace the demon argument and then ask “what are the consequences of this allegiance?” As I hope to show, acceptance of this argument commits one to a belief in the existence of human precognition. This, I suggest, is a consequence that does not fit comfortably within a contemporary scientific worldview. (shrink)

This chapter explores two questions in detail: How should we determine the threshold for costs that individuals are asked to bear through insurance premiums or care-related out-of-pocket costs, including user fees and copayments? and What is an adequate relationship between costs and benefits? This chapter argues that preventing impoverishment is a morally more urgent priority than protecting households against income fluctuations, and that many health insurance plans may not adequately protect individuals from health care costs that threaten to (...) drop their financial status below a decent minimum. A design that places greater emphasis on preventing impoverishment and finances the achievement of that goal by reducing unnecessary subsidies to better-off households would better accord with a sufficientarian approach to health care. -/- . (shrink)

An overview of relational approaches to ethics, which contrast with individualist and holist ones, particularly as they feature in the Confucian, African, and feminist/care traditions.

Since Chenyang Li’s (1994) groundbreaking article there has been interest in reading early Confucian ethics through the lens of care ethics. In this paper, I examine the prospects for dialogue between the two in light of recent work in both fields. I argue that, despite some similarities, early Confucian ethics is not best understood as a form of care ethics, of the kind articulated by Nel Noddings (1984, 2002) and others. Reasons include incongruence deriving from the absence in (...) the Chinese texts of a developed account of need, and doubts about whether the parent-child relationship in Confucian thought is best characterized by ‘care’. More importantly, care is merely one value directing the Confucian commitment to family and personal bonds, with different kinds of relationship, including the five relationships presented in the Mencius, entailing different idealized modes of relating to others. (shrink)

Health care systems can positively influence our personal decision-making and health-related behavior only if we trust them. I propose a conceptual analysis of the trust relation between the public and a healthcare system, drawing from healthcare studies and philosophical proposals. In my account, the trust relation is based on an epistemic component, epistemic authority, and on a value component, the benevolence of the healthcare system. I argue that it is also modified by the vulnerability of the public on healthcare (...) matters, and by the system’s credibility. I apply my proposed analysis of public trust in health care systems to the phenomenon of vaccine hesitancy, a tendency to question vaccine policies, and to seek alternative vaccine schedules or to refuse vaccination. Understanding the role of trust and its components can be key to understanding the phenomenon. (shrink)

Several metaphysical debates have typically been modeled as oppositions between a relationist approach and a substantivalist approach. Such debates include the Bundle Theory and the Substratum Theory about ordinary material objects, the Bundle (Humean) Theory and the Substance (Cartesian) Theory of the Self, and Relationism and Substantivalism about time. In all three debates, the substantivalist side typically insists that in order to provide a good treatment of the subject-matter of the theory (time, Self, material objects), it is necessary to postulate (...) the existence of a certain kind of substance, while the other side, the relationist one, characteristically feels that this is an unnecessary expense and that one can get the job done in an ontologically cheaper way just with inter-related properties or events. In this paper I shall defend the view that there is much less of a disagreement between relational ontologies and substantival ontologies than it is usually thought. I believe that, when carefully examined, the two sides of the debate are not that different from each other, in all three cases of pairs of views mentioned above. As we will see, both the relational side and the substantival side work in the same way, suffer from and answer the same objections, and are structurally extremely similar. It will be an important question – one that I shall discuss in detail, and that is indeed the main point of interest for me in this paper – whether this means that the two sides of the debate are somehow 'equivalent' or not, and what 'equivalent' could mean. (shrink)

I reconsider the concept of dignity in several ways in this article. My primary aim is to move dignity in a more relational direction, drawing on care ethics to do so. After analyzing the power and perils of dignity and tracing its rhetorical, academic, and historical influence, I discuss three interventions that care ethics can make into the dignity discourse. The first intervention involves an understanding of the ways in which care can be dignifying. The second intervention (...) examines whether the capacity to care should be considered a distinguishing moral power – as rationality often is – in light of which humans have dignity. In the third intervention, I cast dignity as a fundamentally relational concept and argue that relationality is constitutive not only of dignity but also of the wider enterprise of normativity. I understand relationality as the condition of connection in which all human beings stand with some other human beings. A thought experiment involving the last person on earth helps to reframe the normative significance of human relatedness. Dignity emerges as fundamentally grounded in relationality. (shrink)

The philosophy of science of Patrick Suppes is centered on two important notions that are part of the title of his recent book (Suppes 2002): Representation and Invariance. Representation is important because when we embrace a theory we implicitly choose a way to represent the phenomenon we are studying. Invariance is important because, since invariants are the only things that are constant in a theory, in a way they give the “objective” meaning of that theory. Every scientific theory gives a (...) representation of a class of structures and studies the invariant properties holding in that class of structures. In Suppes’ view, the best way to define this class of structures is via axiomatization. This is because a class of structures is given by a definition, and this same definition establishes which are the properties that a single structure must possess in order to belong to the class. These properties correspond to the axioms of a logical theory. In Suppes’ view, the best way to characterize a scientific structure is by giving a representation theorem for its models and singling out the invariants in the structure. Thus, we can say that the philosophy of science of Patrick Suppes consists in the application of the axiomatic method to scientific disciplines. What I want to argue in this paper is that this application of the axiomatic method is also at the basis of a new approach that is being increasingly applied to the study of computer science and information systems, namely the approach of formal ontologies. The main task of an ontology is that of making explicit the conceptual structure underlying a certain domain. By “making explicit the conceptual structure” we mean singling out the most basic entities populating the domain and writing axioms expressing the main properties of these primitives and the relations holding among them. So, in both cases, the axiomatization is the main tool used to characterize the object of inquiry, being this object scientific theories (in Suppes’ approach), or information systems (for formal ontologies). In the following section I will present the view of Patrick Suppes on the philosophy of science and the axiomatic method, in section 3 I will survey the theoretical issues underlying the work that is being done in formal ontologies and in section 4 I will draw a comparison of these two approaches and explore similarities and differences between them. (shrink)

This essay considers the dependency of trans youth by bridging transgender studies with feminist care ethics to emphasize a trans wisdom about solidarity through dependency. The first major section of the essay argues for reworking Sara Ruddick's philosophy of mothering in the context of trans and gender‐creative youth. This requires, first, stressing a more robust interaction among her divisions of preservative love, nurturance for growth, and training for acceptability, and second, creating a more nuanced account of “nature” in relation (...) to nurturance for growth to avoid casting transition as contrary to a trans youth's healthy development. In the second major section of the essay, I depart from Ruddick's framework to emphasize the difference of care for trans youth by trans and/or queer communities and through mutual caregiving, stressing a trans wisdom about dependency and solidarity found in the work of Sylvia Rivera and Marsha P. Johnson. Turning to Eva Feder Kittay's links between dependency work and equality, I argue that Rivera and Johnson's work contains a distinct knowledge derived from practice necessitating the connection between solidarity and dependency in particular communities. I then call for more work on trans care ethics, trans ethics, and trans wisdom more broadly. (shrink)

Usually a relational approach, such as one appealing to care or love, is contrasted with an account of justice. In this chapter, however, I argue that distributive justice is well conceived as itself a matter of honouring people in virtue of their capacity to love and to be loved. After spelling out a familiar conception of love, I explain how treating people with respect in light of this capacity provides a plausible basis for human rights, one that rivals influential (...) individualist foundations such as Kantian respect for autonomy and Catholic honor of human life. I also articulate an egalitarian conception of how to allocate wealth that I argue is also a function of treating people's ability to love as special and that can compete against views salient in Anglo-American political philosophy such as cost-benefit analysis and John Rawls’ difference principle. (shrink)

This article engages with the care ethics of Laudato Si’ through the lens of postcolonial ecofeminism. Laudato Si’ speaks of the family of creation where nature is both a nurturing mother and a vulnerable sister, reflecting patriarchal associations of women with nature, fragility, and the virtue of care. This indirectly undermines the need for men to engage in care/social reproduction work as well as the strengthening of women’s agency. While this kin-centric ecology acknowledges the interdependence of creatures, (...) it maintains the hierarchy of humans over nature and underlines this family’s headship by an all-powerful Father. Laudato Si’s family ecology and God language inadvertently reifies women–nature–care connection and reinforces the logic of male domination. This study recommends exploring gender inclusive images of the Trinity and the family of creation in mutual relations to foster care that promotes both the agency of women and nature. (shrink)

According to the care crisis in modern medicine, the existential needs of patients are not sufficiently satisfied. One idea is that to address the crisis physicians should be educated to be virtuous. This suggestion is helpful but incomplete. It does not take into account the part of (non-)human factors, including (medical) technologies. In particular, the paper focuses on online caring forums and argues that they are technological factors that can play the role of focal things, in which the members (...) gather together to do a care-related focal practice. Furthermore, we empirically study the online forums of Ninisite, a popular Persian website on pregnancy, childbirth, and parenting, and suggest that these forums shape focal practices that are helpful in alleviating the care crisis. (shrink)

In the last two decades, the term “quality-of-life” has become popular in medicine and health care. There are, however, important differences in the meaning and the use of the term. The message of all quality-of-life talk is that medicine and health care are not valuable in themselves. They are valuable to the extent that they contribute to the quality of life of patients. The ultimate aims of medicine and health care are not health or prolongation of life (...) as such, but preservation or improvement of the quality of life. The primary aims of medicine and health care, such as the prolongation of life, can – but need not always – come into conflict with the ultimate ones: medical treatments do not always benefit a patient. In this article I will, first, summarize the results of my explorations of the use and the meaning of the term “quality-of-life.” The use and the meaning of the term turn out to depend on the contexts of medical decisionmaking in which it is used. I will show that there are at least three different concepts of quality-of-life. Second, I will argue that the different concepts of quality-of-life are not unrelated. They point to different components of and/or conditions for happiness. Third, I will analyze the relation between the three concepts of qualityof-life, health and happiness. (shrink)

The phrase ‘person‐centred care’ (PCC) reminds us that the fundamental philosophical goal of caring for people is to uphold or promote their personhood. However, such an idea has translated into promoting individualist notions of autonomy, empowerment and personal responsibility in the context of consumerism and neoliberalism, which is problematic both conceptually and practically. From a conceptual standpoint, it ignores the fact that humans are social, historical and biographical beings, and instead assumes an essentialist or idealized concept of personhood in (...) which a person is viewed as an individual static object. From a practical standpoint, the application of such a concept of personhood can lead to neglect of a person's fundamental care needs and exacerbate the problems of social inequity, in particular for older people and people with dementia. Therefore, we argue that our understanding of PCC must instead be based on a dynamic concept of personhood that integrates the relevant social, relational, temporal and biographical dimensions. We propose that the correct concept of personhood in PCC is one in which persons are understood as socially embedded, relational and temporally extended subjects rather than merely individual, autonomous, asocial and atemporal objects. We then present a reconceptualization of the fundamental philosophical goal of PCC as promoting selfhood rather than personhood. Such a reconceptualization avoids the problems that beset the concept of personhood and its application in PCC, while also providing a philosophical foundation for the growing body of empirical literature that emphasizes the psychosocial, relational, subjective and biographical dimensions of PCC. (shrink)

Special volume of "Thaumàzein - Rivista di Filosofia" dedicated to the theme of Socratic Eudaimonia and care for others. It is a multilingual volume comprising twenty papers divided into six sections with an introduction by Linda Napolitano. Edited by Santiago Chame, Donald Morrison, and Linda Napolitano. -/- Despite the appearances given by certain texts, the moral psychology of Socrates needs not imply selfishness. On the contrary, a close look at passages in Plato and Xenophon (see Plato, Meno 77-78; Protagoras (...) 358; Gorgias 466-468; Euthydemus 278; Lysis 219; Xenophon, Memorabilia III 9, 4-5) suggests that the “egoist”’s welfare depends upon the welfare of others (i.e. family, friends or the whole city). Since the welfare of his family, friends and city is part of his own eudaimonìa, the “egoist” (phìlautos) has a direct and intrinsic motive to promote the welfare of these others. -/- This multilingual issue explores the role that other peoples’ welfare plays in Socratic ethics. Special attention is paid to test-cases in which the principle that moral action is always good only for the agent seems to have no validity. I.e., under which circumstances is the self-sacrifice for the sake of others (such as the soldier’s self-sacrifice on the battlefield) good for the agent (as in Alcibiades I 115a-116d)? Essays deal with contradictions or tensions of this sort, and relate them to more general views on eudaimonìa held within Socratic literature. Comparison between different Socratic authors is used as a means to identify the distinctive features of Socratic eudaimonìa if compared to other Greek theories of happiness, such as the Aristotelian theory of philautìa (NE IX, 1166a-1166b; 1168a-1169b). (shrink)

The intersection between virtue and care ethics is underexplored in contemporary moral philosophy. This thesis approaches care ethics from a neo-Aristotelian virtue ethical perspective, comparing the two frameworks and drawing on recent work on care to develop a theory thereof. It is split into seven substantive chapters serving three major argumentative purposes, namely the establishment of significant intertheoretical agreement, the compilation and analysis of extant and new distinctions between the two theories, and the synthesis of care (...) ethical insights with neo-Aristotelianism to generate a virtue ethical theory of care. In the first two chapters, I outline virtue ethics and care ethics, and argue for considerable agreement over central premises. Chapter 2 summarises the foundational commitments of care ethics, focusing particularly on their relational ontology and its links to the other ethical claims care ethicists universally ascribe to, namely particularism, partialism, the moral salience of emotions, and the rejection of hard public/private distinctions. Chapter 3 lays out the central concepts in neo-Aristotelian virtue ethics, including eudaimonism, virtue, and character traits, and drawing a number of comparisons between virtue and care ethics specifically with regard to relational ontology and the meta-ethical commitments it underpins. In addition to doing the necessary expository work for the remainder of the thesis, Chapters 2 and 3 also argue that care ethics and virtue ethics have much more in common than is typically acknowledged – the first major contribution of this thesis to the literature. Chapters 2 and 3 to provide at least a prima facie justification for pursuit of the questions I confront in the remainder of the thesis. In Chapter 4, I ask what differentiates these two ethical theories. I survey some of the differences which philosophers in either camp have identified and offer some of my own. I suggest that several of those differences either rest on misunderstandings of one ethic or the other, or that in erecting a divide between virtue and care ethics they also disunify ethics of care. I do, however, identify two differences which seem defensible. Specifically, they are that virtue ethics seems to lack an account of care, which I define minimally as a response or responsiveness to need, and that virtue and care ethics organise their meta-ethical and normative concepts differently. This chapter thus presents a second contribution to the literature: a study of the differences between virtue ethics and care ethics. It also serves to set the trajectory for the remaining chapters, where I respond to the claim that virtue ethics lack an account of care. I spend the remainder of the thesis constructing what I take to be a satisfying foundation for a virtue ethical theory of care. In Chapter 5, I offer three initially viable means of incorporating care into virtue ethics, all of which treat care as a virtue. These are the analogical approach, according to which care is analogous to an existing virtue; the additive approach, according to which care is a novel virtue; and the bundling approach, according to which care is a bundle of virtues. I also offer and evaluate reasons to reject the claim that care is a virtue, concluding that the claim is indeed a viable one so long as the concept of care is sufficiently thick, and I contend that analogical approaches, and particularly analogies with charity, outperform the others. Chapter 5 therefore serves two ends. First, it proffers a novel meta-analysis of concepts of care as a virtue, and thus makes a third contribution to the literature. In doing so, it makes an inroad into the second: the development of a neo-Aristotelian theory of care. Chapter 6 continues this project. I attempt to show how care can be construed as an act-type and a practice. I argue in this chapter that practices are a subcategory of actions, and that care qualifies as an Anscombean act-type which aims at the meeting of needs relating to the care-recipient’s flourishing. I go on to consider the implications of this account for ethics which deploy care as a moral concept, maintaining that it not only offers a better account of consequences than theories of care which include success criteria, but also that it affords us interesting insights into the distinction between ‘caring about’ and ‘caring for’ which allow us to make sense of certain tenets of neo-Aristotelianism. This represents a contribution to both discourses, since neither care nor virtue ethicists working at the intersection of their respective normative theories have delved very deeply into the philosophy of action. Chapter 7 discusses caring relations, suggesting that a virtue ethical theory of caring relations can lean on the work care ethicists have done, and adding some necessary refinements, such as a distinction between ideal and non-ideal caring relations, and a theory of caring relations as reasons for action. This final chapter also draws these three concepts of care together by arguing that virtuous caregivers who are invested in the flourishing of those for whom they care are also sensitive to the relations those care-recipients bear to their institutional environment. I argue that because they are caring participants in caring relations, virtuous agents are characteristically motivated by states of need and dependency to engage in certain sorts of conventionally political practices. In other words, the virtue or virtues of caring characteristically manifest in certain sorts of political or social practices, relating specifically to those areas of moral life. This allows us to build upon recent work in feminist virtue ethics of the sort offered by Tessman and Friedman. I also offer a novel analysis of migration, suggesting that the account of care presenting here is analytically useful both when it comes to historical cases of migration such as the underground railroads and escapes from Nazi-occupied Europe, but also for contemporary issues such as the migrations occurring in the Southern United States and in much of Europe. I thus conclude not only that virtue ethicists ought to incorporate care into their normative framework, and that the theory of care presented here is a coherent one, but that this leads us naturally into applied topics such as virtue politics. I conclude the thesis by considering some its implications and by identifying some further avenues for research. (shrink)

The core idea of A Relational Theory of Justice is that normative political and legal philosophy should be grounded on people’s relational features, in particular their ability to commune with others and be communed with by them. Usually, philosophers of justice in the West have based their views on people’s intrinsic features, ones that make no essential reference to others, such as their autonomy, self-ownership, or well-being. In addition, often critics of basing politics and law on justice, whether in the (...) African, feminist/care, Marxian, or Confucian traditions, have appealed to non-intrinsic values as leverage, roughly contending that relationships are more important than justice. In contrast to both major camps, this book articulates and defends accounts of justice based on the dignity of people’s relational nature. A proper valuation of people’s capacity to be party to communal relationships does not transcend categories of justice, but instead calls for certain sorts that differ in plausible ways from those grounded on intrinsic properties. Applications are discussed in the contexts of political, economic, compensatory, criminal, transitional, and global justice. Available for download is the Table of Contents. (shrink)

The internet of things is increasingly spreading into the domain of medical and social care. Internet-enabled devices for monitoring and managing the health and well-being of users outside of traditional medical institutions have rapidly become common tools to support healthcare. Health-related internet of things (H-IoT) technologies increasingly play a key role in health management, for purposes including disease prevention, real-time tele-monitoring of patient’s functions, testing of treatments, fitness and well-being monitoring, medication dispensation, and health research data collection. H-IoT promises (...) many benefits for health and healthcare. However, it also raises a host of ethical problems stemming from the inherent risks of Internet enabled devices, the sensitivity of health-related data, and their impact on the delivery of healthcare. This paper maps the main ethical problems that have been identified by the relevant literature and identifies key themes in the on-going debate on ethical problems concerning H-IoT. (shrink)

Adaptation and stress are two main concepts useful for better understanding the phases of illness and health-related human behavior. The two faces of adaptation, adaptation as a process and adaptation as a product, have raised the question of how long the adaptation process will take in cancer trajectories. The care setting transition from clinical-based into home-based cancer care has stressed the role of family caregivers (FCG) in cancer management. This study examines how types of demanded healthcare information affect (...) the FCG’s role in catalyzing the adaptation of female cancer patients. The mindsponge theory was used in conceptual development and results interpretation. Bayesian Mindsponge Framework (BMF) analytics was used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of demanded healthcare information, FCGs with a higher tendency to demand cancer-specific information are more likely to need support in catalyzing the adaptation of female cancer patients. Meanwhile, FCGs with a higher demand for information on alternative therapies are less likely to need support in catalyzing cancer adaptation. Other types of healthcare information have ambiguous effects on the need for support in cancer adaptation assistance. This study reveals that the demanded cancer-specific information, e.g., cancer’s prognosis or likely outcome, must be prioritized to assist FCG’s role in catalyzing adaptation among female cancer patients. Cancer prognosis and outcomes reflect the future of cancer care results. (shrink)

An Islamic approach from its theological sources to address the spiritual pain related to palliative care of terminally ill patients can be established on attaining a spiritual stage of soul or spirit termed as reassured soul. The attainment of such stage is based on hope of the patient to receive mercy and forgiveness of God. And the way of attainment of hope is possible by doing the repentance, praying, and patience. In combating the pain and suffering, the patient is (...) supposed to understand that the life in its reality is a test and facing such a test is possible by two ways, one is patient centric by building patience within to endure the suffering and second is seeking help from God by praying. For the spiritual wellbeing, the patient should understand that his suffering is in fact expiation for his sins. On the other hand, the visitors and caregivers of patients have certain responsibilities that contribute to enhancing of the spiritual well-being of the patient, including comforting them by giving hope to the patients and at the same time praying for their recovery. These all elements enhance the spiritual well-being of patients and help in prevention of suffering by spiritual means. (shrink)

Patient-centered care (PCC) is an approach to healthcare that values patients’ preference, need, and autonomy. The estimation of healthcare partly depends on how well PCC is implemented. In addition, the result of clinical research can inform the assessment of the implementation of PCC. In clinical research, health-related quality of life (HRQL) theoretical models offer a conceptual toolbox that informs clinical research and guides the hypotheses generation. Wilson and Cleary (1995) developed the most widely used HRQL theoretical model (Bakas et (...) al., 2012). Ontological assumptions about causation in Wilson and Cleary’s model will influence which kind of hypotheses will be generated. I will argue that Wilson and Cleary’s model instilled a kind of causal bias into hypothesis generation in clinical research on HRQL. Causation from biomedical factors to non-biomedical factors is frequently hypothesized while causation from non-biomedical factors to biomedical factors is rarely hypothesized. It leads to that the interdependence and interaction between constituent parts of patients are ignored, which is an obstacle to the implementation of PCC. In addition, I will propose a revised HRQL theoretical model which avoids the causal bias brought by Wilson and Cleary’s model. By doing so, I leave room for the improvement of the practice of healthcare by analyzing the ontological assumptions about causation. (shrink)

Dispositionalism is the theory of modality that grounds all modal truths in powers: all metaphysically possible and necessary truths are to be explained by pointing to some actual power, or absence thereof. One of the main reasons to endorse dispositionalism is that it promises to deliver an especially desirable epistemology of modality. However, so far this issue has not be fully investigated with the care it is due. The aim of this paper is to fill this gap. We will (...) cast some doubts on whether the dispositionalist really is in a better position to explain our modal knowledge. In fact, we argue that there is a tension between some core tenets of a powers metaphysics and the very features that make dispositionalism the ideal backdrop for a desirable epistemology of modality. We conclude that this leaves dispositionalists who want to deliver the promised epistemology with a hard, currently unfulfilled, task. (shrink)

Background Bronchial asthma is one of the most common chronic conditions among children. Despite the improvement in asthma treatment regimens, its prevalence and related morbidity are increasing, especially among underserved, minority children. There are barriers in the management of asthma, which may impact the quality of outcomes. The goal of this study is to explore these barriers. Methods A cross-sectional study was conducted on interview data collected through 2019 from mothers of children (aged 6 - 12 years) with asthma visiting, (...) for convenience, a public shopping mall. The interviewees were randomly selected, because they met the inclusion criteria. Participants were considered if the mother answered “yes” to the following questions: Has your child had physician-diagnosed asthma? Is your child currently taking asthma medications of asthma? Two community nurses conducted the interviews. Data was obtained using administrative questionnaires. Data were analyzed using SPSS version 21.0 (IBM Inc., Chicago, IL, USA). Descriptive statistics of percentage, mean, frequency and standard deviation were applied for categorical and continuous variables. Results Three hundred mothers participated in this study. Their average age was 36.8 years, 55% were housekeepers by profession, and 34% had obtained less than high school education. The majority of children (61%) were males, 45% had moderate asthma, and 42% had mild asthma. The most frequent types of barriers identified by parents were environmental factors (67.7%), followed by health care providers (63%), the health care system (48%), and patient or family characteristics (43%). Mothers were specifically concerned about the use, safety, and long-term complications of medications, the impact of exercise limitation on their child’s quality of life, and their own quality of life. Conclusion This study showed several barriers against asthma care in Saudi Arabia, which mainly related to environmental or personal characteristics. This highlights the need to enhance current policies within the health care system in Saudi Arabia to overcome these barriers. (shrink)

The conjunction of wireless computing, ubiquitous Internet access, and the miniaturisation of sensors have opened the door for technological applications that can monitor health and well-being outside of formal healthcare systems. The health-related Internet of Things (H-IoT) increasingly plays a key role in health management by providing real-time tele-monitoring of patients, testing of treatments, actuation of medical devices, and fitness and well-being monitoring. Given its numerous applications and proposed benefits, adoption by medical and social care institutions and consumers may (...) be rapid. However, a host of ethical concerns are also raised that must be addressed. The inherent sensitivity of health-related data being generated and latent risks of Internet-enabled devices pose serious challenges. Users, already in a vulnerable position as patients, face a seemingly impossible task to retain control over their data due to the scale, scope and complexity of systems that create, aggregate, and analyse personal health data. In response, the H-IoT must be designed to be technologically robust and scientifically reliable, while also remaining ethically responsible, trustworthy, and respectful of user rights and interests. To assist developers of the H-IoT, this paper describes nine principles and nine guidelines for ethical design of H-IoT devices and data protocols. (shrink)

In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats—or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the (...) broad middle terrain—and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the “manipulation” label and relabeling this space “nonargumentative]influence,” with two subtypes: “reason-bypassing” and “reason-countering.” Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to the surgery. (shrink)

I outline and defend two egalitarian theories, which yield distinctive and, I argue, complementary answers to why health-related inequalities matter: a brute luck egalitarian view, according to which inequalities due to unchosen, differential luck are bad because unfair, and a social egalitarian view, according to which inequalities are bad when and because they undermine people’s status as equal citizens. These views identify different objects of egalitarian concern: the brute luck egalitarian view directs attention to health-related well-being, while social egalitarianism focuses (...) on health-related capabilities that are central to a person’s status as a citizen. I argue that both views are correct and should jointly guide priority-setting in health. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment (...) to both distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

International relations (IR) scholars have increasingly integrated Hannah Arendt into their works. Her fierce critique of the conventional ideas of politics driven by rulership, enforcement, and violence has a particular resonance for theorists seeking to critically revisit the basic assumptions of IR scholarship. Arendt’s thinking, however, contains complexity and nuance that need careful treatment when extended beyond domestic politics. In particular, Arendt’s vision of free politics—characterized by the dualistic emphasis on agonistic action and institutional stability—raises two crucial issues that (...) need further elaboration for IR research that appropriates her thinking. One involves the orientation of her international thoughts. Although Arendt shows “idealistic” aspirations for authentic politics practiced by diverse equals in an institutionally articulated space of freedom, she never loses interest in the extant situation of “non-idealistic” politics. Engaging with Arendt’s theory orientation requires a careful analysis of difficult topics, such as her distinctive conception of the political and her critiques of the nation-state and international law. The other topic that needs clarification when Arendt’s thoughts are applied to IR involves specific ways of associating different sites of power. A close examination of Arendt’s council-based federalism reveals her distinctive idea of international politics, based on her acute awareness of the fundamental complexity that lies in power association and state agency. Bringing IR topics like state agency into conversation with her works generates illuminating questions for Arendt scholarship. Likewise, the ongoing debate on agonistic and institutional features of Arendt’s thoughts can provide crucial insights into critical studies of international politics. (shrink)

In her Nobel speech in 2019, Olga Tokarczuk presented the category of tenderness as a new way of narrating the contemporary world. This article is a proposal for the analysis and interpretation of tenderness in ethical and aesthetic terms. (1) From an ethical perspective, tenderness is interpreted as an extension and complement of feminist relational ethics, i.e., the ethics of care. In the proposed approach, tenderness is a broader and more universal quality than care in the feminist understanding. (...) This article opens with a brief discussion of feminist interventions in ethics, with particular emphasis on the ethics of care. Next, the differences between care and tenderness are enumerated and described, in order to show how tenderness can serve as an extension and complement of the feminist ethic of care. These considerations are guided by the question of why tenderness is a better—more appropriate and more responsive to contemporary challenges—moral guidepost than care. (2) From the aesthetic perspective, tenderness is the negation of a contemplative, distanced, impersonal, and rational view of reality. As an aesthetic imperative, tenderness implies engaged experience of the beauty of reality in all of its manifestations. Therefore, in the last part of the article, existential tender attunement is described in aesthetic terms, as a position serving to sensitize others to the beauty and complexity of the post-anthropocentric world. (shrink)

This article draws upon the work of Timothy Morton and Slavoj Žižek in order to critically examine how mountain bike trail builders orientated themselves within nature relations. Beginning with a discussion of the key ontological differences between Morton’s object-oriented ontology and Žižek’s blend of Hegelian-Lacanianism, we explore how Morton’s dark ecology and Žižek’s account of the radical contingency of nature, can offer parallel paths to achieving an ecological awareness that neither idealises nor mythologises nature, but instead, acknowledges its strange (...) and contingent form. Empirically, we support this theoretical approach in interviews with twenty mountain bike trail builders. These interviews depicted an approach to trail building that was ambivalently formed in/with the contingency of nature. In doing so, the trail builders acted with a sense of temporal awareness that accepted the radical openness of nature, presenting a ‘symbolic framework’ that was amiable to nature’s ambivalent, strange and contingent form. In conclusion, we argue that we should not lose sight of the ambivalences and strange surprises that emanate from our collective and unpredictable attempts to symbolize nature and that such knowledge can coincide with Morton’s ‘dark ecology’ – an ecological awareness that remains radically open to our ecological existence. (shrink)

English-speaking research on morally right decisions in a healthcare context over the past three decades has been dominated by two major perspectives, namely, the Four Principles, of which the principle of respect for autonomy has been most salient, and the ethic of care, often presented as a rival to not only a focus on autonomy but also a reliance on principles more generally. In my contribution, I present a novel ethic applicable to bioethics, particularly as it concerns human procreation, (...) that I argue is a promising alternative to these two approaches. According to this new moral theory, an act is right just insofar as it treats people’s capacity to commune with respect, where communing is a matter of identifying with others and exhibiting solidarity with them. This ethic is inspired by relational ideals of communion and harmony from the African philosophical tradition, but is shown to be attractive to a broad, indeed global, audience, with regard to its implications for the morality of reproduction. (shrink)

In this article, I address what kinds of claims are of the right kind to ground conscientious refusals. Specifically, I investigate what conceptions of moral responsibility and moral wrongness can be permissibly presumed by conscientious objectors. I argue that we must permit HCPs to come to their own subjective conclusions about what they take to be morally wrong and what they take themselves to be morally responsible for. However, these subjective assessments of wrongness and responsibility must be constrained in several (...) important ways: they cannot involve empirical falsehoods, objectionably discriminatory attitudes, or unreasonable normative beliefs. I argue that the sources of these constraints are the basic epistemic, relational, and normative competencies needed to function as a minimally decent health-care professional. Finally, I consider practical implications for my framework, and argue that it shows us that the objection raised by the plaintiffs in Zubik v. Burwell is of the wrong sort. (shrink)

Political theory and philosophy need to widen their view of the space in which what matters politically takes place, and I suggest that integrating the conditions of sustainability of all affected—that is, all participants in nature's relations—is a necessary first step in this direction. New materialists and posthumanists have challenged how nature and politics have traditionally been construed. While acknowledging the significance of their contributions, I critically examine the ethical and political implications of their ontological project. I focus particularly (...) on how the decentering of human agency that they advocate for raises a set of concerns that need to be addressed in developing an appropriate ecological ethics. I argue that the latter must be attuned to the vulnerability of living beings who participate in relationships that sustain life on earth. This brings me to conclude that qualitative distinctions between the worlds ofbiosandtechneare necessary. This is because we need to think critically about ways of evaluating types of relationships so that we can assess them and establish which are worth nurturing and protecting and which are not. (shrink)

Patient and public involvement is widely thought to be important in the improvement of health care delivery and in health equity. Purpose: The article examines the role of experiential knowledge in service co-production in order to develop opiate substitution treatment services (OST) for high-risk opioid users. Method: Drawing on social representations theory and the concept of social identity, we explore how experts’ by experience and registered nurses’ understandings of OST contain discourses about the social representations, identity, and citizenship of (...) the participants and the effects these may have on developing or hindering inclusive and bottom-up forms of patient and public involvement. Results: The meeting sessions that potentially offer room for creativity and problem-solving fail to provide any new propositions for fixing the system. The health care professionals primarily identify themselves as regulators who protect the correctness of their actions and show little interest in considering experiential knowledge on opioid addiction. Conclusion: The participation of patients has been one of the prominent reforms implemented in health care. The goal of client-centered thinking is often emphasised; however, the implementation is not simple due to the strongly institutionalised knowledge and related working patterns and practices in health care. (shrink)

While agreeing with the main conclusion of Dominic Wilkinson and colleagues (Wilkinson, Butcherine, and Savulescu 2019), namely, that there is no moral difference between treatment withholding and withdrawal as such, we wish to criticize their approach on the basis that it treats the widespread acceptance of withdrawal aversion (WA) as a cognitive bias. Wilkinson and colleagues understand WA as “a nonrational preference for withholding (WH) treatment over withdrawal (WD) of treatment” (22). They treat WA as a manifestation of loss aversion (...) and refer to Kahneman and colleagues (1991), which defined this effect as follows: “the disutility of giving up an object is greater that the utility associated with acquiring it” (194). In a previous work, Wilkinson and Savulescu understood nonequivalence between treatment withholding and withdrawal as a reflection of slightly different, although related, phenomena: status quo bias or omission bias (Wilkinson and Savulescu 2012, 130–131). In neither of these two papers do they describe precisely the relation between these well-known psychological effects and WA, nor do they explain why they treat these effects as examples of nonrational preferences, despite the fact that these issues have been the subject of wide-ranging discussions on the intersection of psychology, economy, and philosophy. (shrink)

How can work be a genuine good in life? I argue that this requires overcoming a problem akin to that studied by Marx scholars as the problem of work, freedom and necessity: how can work be something we genuinely want to do, given that its content is not up to us, but is determined by necessity? I argue that the answer involves valuing contributing to the good of others, typically as valuing active pro-sociality – that is, valuing actively doing something (...) good for others. This makes work better in one way, and may even make work something we are genuinely glad to have in our lives. Contemporary philosophical thinking about good work tends to focus on how work can be good for the person doing it, by providing, for example, self-realization or social relationships, while underappreciating the special importance of valuing social contribution. People will typically only really want work if they want a part of their lives to be about the good of others. This also means that work may be a part of the best life, something we should take into account when discussing work-related policies and the desirability of a ‘post-work’ future. (shrink)

According to many of its proponents, shared decision making ("SDM") is the right way to interpret the clinician-patient relationship because it respects patient autonomy in decision-making contexts. In particular, medical ethicists have claimed that SDM respects a patient's relational autonomy understood as a capacity that depends upon, and can only be sustained by, interpersonal relationships as well as broader health care and social conditions. This paper challenges that claim. By considering two primary approaches to relational autonomy, this paper argues (...) that standard accounts of SDM actually undermine patient autonomy. It also provides an overview of the obligations generated by the principle of respect for relational autonomy that have not been captured in standard accounts of SDM and which are necessary to ensure consistency between clinical practice and respect for patient autonomy. (shrink)